{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Michael Morgan","gend":0,"add":"1220 Wax Rd SE","city":"Silver Creek","state":"GA","zip":30173,"dob":"1963-05-17","age":"","mstatus":"","insh":4353480001,"cliId":"","pno":7067281826,"cno":"","email":"Tishaleighann7590@gmail.com","ename":"","eno":"","pphy":"James Ware","ppno":"","pcpadd":"330 Turner McCall Blvd","pcpcity":"Rome","pcpstate":"GA","pcpzip":"","pcpcounty":"Rome","pcpid":"","pcpname":"","plan":"ALLIANT","program":"ACA","lob":"","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C22.0","Z51.11","B18.2","K26.9","Z66","C20","I10","R09.89","Z12.5","E55.9","E53.8","Z68.24","Z71.3","Z71.89","C78.00","C80.1","Z51.12","K21.00","I85.10","K74.60","K26.3","R53.83","I65.29","I65.23","K29.70","K29.60","M79.604","M79.605","R60.0","I85.00","K31.89","F17.208","G47.62","G89.3","R21","C78.7","C34.90"],"date":["2021-12-28","2021-08-04","2021-12-28","2021-05-04","2021-04-20","2021-05-11","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2021-05-25","2021-05-25","2021-08-24","2021-05-04","2021-05-04","2021-05-04","2021-05-04","2021-11-02","2021-12-28","2021-12-28","2021-05-04","2021-05-18","2021-11-23","2021-11-23","2021-11-23","2021-05-18","2021-05-18","2021-08-17","2021-08-17","2021-08-17","2021-08-17","2021-05-25","2021-05-25"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[]}]},{"t":"Medical History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Family History","q":[{"a":[]}]},{"t":"Preventive Care","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","65862039010","ONDANSETRON","ODT4MGTABLET","24","Select","Select",""],["","68180098003","LISINOPRIL","10MGTABLET","30","Select","Select",""],["","62175061743","PANTOPRAZOLE","SODDR40MGTAB","30","Select","Select",""],["","10702005601","OXYCODONE","HCL(IR)10MGTAB","90","Select","Select",""],["","68180072103","AMLODIPINE","BESYLATE10MGTAB","30","Select","Select",""],["","93227534","AMOX-CLAV","875-125MGTABLET","20","Select","Select",""],["","42806016005","HYDROXYZINE","HCL25MGTABLET","30","Select","Select",""],["","70377000612","ROSUVASTATIN","CALCIUM5MGTAB","30","Select","Select",""],["","59779060027","CVS","ASPIRINEC81MGTABLET","30","Select","Select",""],["","68180012202","CEPHALEXIN","500MGCAPSULE","21","Select","Select",""]]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Review of Systems and Diagnoses","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"","a10":[],"a11":"","a12":"","a13":""}]}]}